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[TKR] 12 weeks with a new knee

Discussion in 'Knee Replacement Recovery Area' started by Newboots, Oct 7, 2018.

  1. Newboots

    Newboots member
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    Yes that’s fine. Thank you.
     
  2. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Here y'go then!

    It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

    1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

    2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

    3. how swollen is your leg compared to these?
    ai63.tinypic.com_eta39s.jpg

    4. what is your ROM - that's flexion (bend) and extension (straightness)

    5. are you icing your knee at all? If so, how often and for how long?

    6. are you elevating your leg. If so how often and for how long?

    7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

    8. are you doing any exercises at home? If so what and how often?
    This is the most crucial question so please help me by using the format I have left as an example
    (which means please make a list and not an essay!)

    Exercises done at home
    - how many sessions you do each day
    - enter exercise by name then number of repetitions of each
    etc., etc.

    Anything done at PT
    - how many times a week
    - enter exercise by name then number of repetitions of each
    etc., etc.
     
  3. Newboots

    Newboots member
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    Ok here goes-
    1. Between 3 and 4 and it’s mostly stiffness

    2.Cocodamol 15mg/500mg x2 4 times a day
    Tramadol 50mg 1 or 2 during the night as needed

    3.Moderate swelling

    4. Rom 90 and don’t know what my extension is

    5. Yes icing my knee with gel packs at night when I go to bed and during the day when I have leg elevated. About 5 times a day for about 40 mins and then the bedtime ice.

    6.Elevating knee on a lounge doctor 6hrs a day in total broken up into 2 hr sections

    7.Doing minimal cooking mainly ready meals and have a stool to sit on whilst doing any prep. Fill and empty dishwasher. Have put washing on but daughters hanging it out. Putting away clothes in bedroom.
    House on 3 levels so have to go down a flight of stairs to laundry room and to get outside.
    Daughters are doing hoovering ,bins etc.

    8. 3/4 sessions a day
    Heel slides x5
    Leg extensions x 5

    Then 5 min walk around the cul de sac daily and beginning to make this a little bit longer.

    9. Went to physio session last week and although they weren’t pushing me I suffered the next night from pain and swelling which reduced after a day of complete rest.
    At this session I did 2 mins of heel slides
    2 mins rocking pedals
    2 mins heel slides using a skateboard
    2 mins leg extension pressing thigh onto bed
    2 mins of standing leg lifts to the side and 2 mins leg lifts to the back
    2 mins seated leg raises and holds
    2 mins with roll under knees and lifting and holding leg
    I’m not doing this again......
     
  4. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Okay
    Given you are only about 3 weeks out when you wrote these answers, your medication schedule is not good. I suggest you stick with the Tramadol and use this routine for your meds - paracetamol is Tylenol.

    aa Tramadol routine 4.JPG

    and I am assuming you factored this into your overall pain score, yes?
    You can assess that yourself using this procedure:

    1. put your leg on a bench, seat, bed, floor or anything similar but preferably something fairly firm.
    2. with not too much pressure, press the back of your knee down - use your leg muscles, not your hand!
    3. slide your hand, palm down, under the back of your knee
    a) if you can get your entire hand under easily, it's probably about +10 degrees
    b) if you can get just your fingers under, it's about +5
    c) if you can get your fingers under but it's a push, it's +0
    d) if you can't get your fingers under at all, it's -5 or more​

    Here's a graphic to explain the degrees involved

    [​IMG]

    Let me know what you find.
    that's okay
    Good
    Sound like you have it all arranged!

    3-4 sessions a day - okay but once a day is plenty and none at all at the weekend!
    Heel slides x5 - since your flexion is 90, you shouldn't need to do these
    Leg extensions x 5 - I doubt you need these either
    5 min walk around the cul de sac daily - depends how far that is!

    Went to physio session last week and although they weren’t pushing me I suffered the next night from pain and swelling which reduced after a day of complete rest - good sign that they were pushing you!
    2 mins of heel slides
    2 mins rocking pedals
    2 mins heel slides using a skateboard
    2 mins leg extension pressing thigh onto bed
    2 mins of standing leg lifts to the side and 2 mins leg lifts to the back
    2 mins seated leg raises and holds
    2 mins with roll under knees and lifting and holding leg

    None of these are beneficial and may be causing your pain.

    I suggest you make the adjustments in your pain meds I have suggested.
    Stop the PT and exercising - you don't need it.

    If you are concerned about refusing to do therapy, you need to read this Saying no to therapy - am I allowed to?
     
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  5. Newboots

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    Thanks for taking the time to do this Josephine.
    Re no 3 yes pain score takes into account the swelling. Recently have been having more swelling on my ankle and lower leg so more of a constant 4

    Re no 4 Using your measurement method It’s +5

    Re exercise- the walk around the cul de sac is 5 mins at a snails pace! Probably about 200 metres max.
     
  6. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    I see
    Well that's okay. You're not 4 weeks out yet so still plenty of time to get there!
    Oh that's not far, is it!
     
  7. Newboots

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    Please can an administrator change my thread title to ‘4 Weeks Out with the new knee’
    Thanks
     
  8. skigirl

    skigirl FORUM ADVISOR Forum Advisor

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    I changed the title for you. I found that I felt better at four weeks and really turned a corner at 8 weeks. At four weeks my doc told me to lie with leg elevated for two hours for every one hour that i was up. Make sure you are getting enough rest.
     
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  9. Newboots

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    Thanks for that and what god advice from your doc! I am actually doing that elevation right now!
     
  10. Newboots

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    Ok it’s nearly 5 weeks now and I have to say I can see progress .
    Am lucky to have friends to come and take me out for lunch or to some flat place to walk It’s quite hilly where I am. We’ve had gorgeous Autumn days so it’s so good to be outside. Did 30 mins around a lake the other day on one crutch and I’m doing exercise bike about 7 mins a day now.

    Not needing the pain meds as much so down to 3 times a day and none in the night. Sleeping for 4 hr blocks at night. Also still having sleeps during the day in the afternoon whilst I ice and elevate.
    Because it’s only 11 moths since I had first knee replaced and that knee has been taking a lot of the weight It’s feeling a bit more tender /stiff . Not painful but I can tell it’s complaining.

    Like others want to do more and feel frustrated at the slowness of my walking pace. Not really using my crutch inside except for the stairs.

    Whilst going through recovery have been trying to find a care home for my 95 year old Dad, he was taken into the same hospital where I was having my knee done ! He’s out now and has carers looking after him but really needs more support which I can’t give. The timing is not great! My sister who lives in France is coming over this week to help sort something out for him before she has her second knee done!

    One thing I solved today was the morning tea in bed issue. Being mainly on my own I’d been taking milk in a flask upstairs every night in my little back pack so I can make tea in the night or early morning. I’ve got a travel kettle in the bedroom.It’s a bit of a chore though so today I got up made tea downstairs and brought it back upstairs in a thermos flask to enjoy in bed. Silly I know but it made me Happy!

    Also have been getting all my shopping delivered by Sainsbury’s with a v helpful delivery man who brings the shopping to my upstairs kitchen. That and my great neighbour who gets me a newspaper every day has been so helpful.

    Today’s plan is to drive up to my allotment with a friend to pick the remaining apples off my little apple tree or go apple scrumping as she said. She can carry the apples and I’ll concentrate on the walking.

    Good luck to fellow bonesmarters in this long and arduous recovery!
     
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  11. Newboots

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    Well got my Dad into a Care Home ok and he's happy so big relief.
    Back to the knee. Have a question for Bonesmarters who are on their other knee replacement. Had my first right knee done about a year ago and it had got really strong. Now 7 weeks out with new lefty but my right knee is really complaining. Not painful but very sensitive and stiff going downstairs. It's taking the weight I suppose as still going down one foot at a time.Anyone else had this sort of problem ?
     
  12. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    Your right knee is still not healed all the way, so it's complaining about taking on all the work. It would probably help to ice and elevate both knees
     
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  13. Newboots

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    Thanks . It's what I thought but it had seemed so strong before the op. I could have had the second op much earlier but thought I'd give the first chance to heal .Hey ho these knees . Recovery seems slower second time around but it maybe that Im just imagining it was a quicker recovery last time .
    My sister is having her second knee done today in France. She lives on a canal boat so will be going into rehab for 2 weeks for her recovery! I think they have them outside walking at 8 o'clock in the morning before breakfast !
    I can't imagine ….
     
  14. Newboots

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    Please can a moderator update my thread title to ‘12 weeks with a new knee’ thanks.
     
  15. Newboots

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    12 weeks from op now and I haven’t posted much because I was waiting to feel I’d made some more progress but I have to say it’s been very slow coming. I can’t help comparing it with my first tkr when I seemed to be much further along by this point in time.
    Things I can do are - Drive my car for short journeys, walk for 40 mins albeit slowly, easily put my shoes on,get dressed standing up and navigate the swimming pool changing rooms.Can do about 20 mins in the pool but not kicking with my new knee.
    Things that are still a problem: pain and swelling... still having to ice and be careful I don’t join that popular club the ODIC, sleep is still a bit erratic . I think the new knee is quite sensitive still and wakes me up when it gets in an uncomfortable place..My first knee has joined in and aches in sympathy with its mate.I don’t think it likes doing all the stairs in my house and the new knee hates changing gear so I just promise them more ice and a golden future together.

    Christmas was a bit strange as I had no enthusiasm for doing decorations etc. But on the plus side can now stand up and talk to people at social gatherings without feeling I have to sit down all the time.Really good news that my 14 year old grandson who has had complex regional pain syndrome for over a year after osteomyelitis is now walking with just a walking stick and able to put 2 feet on the ground. Whenever I feel sorry for myself I think of him.
    Also have sibling knee rivalry as my sister had another tkr in France at the end of November and is having one of those amazing rapid recoveries..... I know every knee is different!

    So looking forward to a relatively painfree and healthy New Year and hope for the same for everyone going through this recovery .:) :-) (:
     
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  16. Mom2Lucy

    Mom2Lucy senior

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    @Newboots , I’m right there with you, as we’re only a day apart.
    Sounds like (my slower than hoped for )recovery. I do think you’re doing well in being able to walk 40 mins.... The pain and swelling , the erratic sleep, oh yeah, we are so sharing this path.:console2:
     
  17. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    It's perfectly understandable that you weren't that excited about putting up Christmas decorations. This surgery takes a whole lot out of a person. The Christmas holidays are hectic enough without recovering from a knee replacement!

    Your old knee is having to take on almost all the work now and is fussing about it. As your new knee gets stronger and takes on more, your old knee will start to feel better. Icing both at the same time is a good idea!
     
  18. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Your first knee is still in early recovery and the energy drain for 2 recoveries is very real.
     
  19. Newboots

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    Thanks @Mom2Lucy it’s good to know we’re not alone in this long recovery .I liked what @kmak81230 said about “taking the scenic route to recovery “ !
    Today going to go for a short swim if it’s not too busy. I don’t like it when there’s lots of children in the pool ... I feel very protective of my knee! Probably will need to ice afterwards but I just enjoy the exercise.

    @Jockette and @sistersinhim yes thanks for the reminder .I think when i hear of people having bilaterals done and coping well with that recovery I feel I should be further along . I just have to accept that my knees heal differently.
     
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  20. beachy

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    It sounds like you're able to do many things!
    I don't think I can walk for 40 min. Maybe half of that before the knee starts swelling. I haven't been in a pool.
    And I haven't decorated for the last 3 Christmas's! We go to my son's and he likes to decorate. Have at it!
    I'm 11 weeks today with a little setback, but that will go away too. I bet in 2 weeks you'll feel like a new woman!
     
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